Osage Hills Christian Church - Medical and Release Form

Please fill out a permission form for each member of your family who will be participating in Osage Hills Trips, Events, and Regular programming.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The above listed participant has my permission to attend Osage Hills Christian Church trips and activities. This consent form gives permission to seek whatever medical attention is deemed necessary, and releases Osage Hills Christian Church and its staff/volunteers of any liability against personal losses of named participant.

I/We the undersigned have legal custody of the participant named above, a minor. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release Osage Hills Christian Church, its pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our student’s involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by Osage Hills Christian Church, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the participant named above. I/we also agree to bring my/our student home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.

I/We grant Osage Hills Christian Church the right to use images, videos, and various forms of media including church run social media and websites for lawful purposes, commercial and noncommercial.
Please select all that apply.

Description

Please fill out a permission form for each member of your family who will be participating in Osage Hills Trips, Events, and Regular programming.